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Creating SNF Preferred Provider Networks to
Drive Quality Outcomes
Session #296, February 15, 2019
Donna Peters, MBA, Director IT, Applications Solution Center
Lori Baker, MSOL, MSW, LSW Director Ambulatory Care Management/ Post Acute
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Lori Baker MSOL, MSW, LSW
Donna Peters, MBA
Has no real or apparent conflicts of interest to report.
Conflict of Interest
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• Learning Objectives
• TriHealth At A Glance
• Local Problem
• What is Advanced Quality Outcomes
• Project and Technology Evolution
• Tactics To Drive Outcomes
• Results
• Questions
Agenda
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• Explain the challenges of measuring skilled nursing facility
performance
• Demonstrate methodology to discretely measure the quality of
care provided in skilled nursing facilities as a care partner
• Discuss outcomes of quality improvement program aimed at
improving the outcomes of our skilled nursing home patient
populations
Learning Objectives
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TriHealth At A Glance
Four acute-care hospitals
with 900 adult-staffed
beds
One short-stay surgical
hospital
Two free-standing
outpatient surgery
centers
Over 140 outpatient
service locations
Over 150 physician
practice locations
Over 850 employed
physicians
Over 1,800 physicians on
medical staff
Over 14,000 employees
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>125 SNFs in
Cincinnati Market
TriHealth does not
own any SNF
Data was being
captured
manually on
spreadsheets
Collaborated with
SNFs with highest
quality to achieve
triple aim
Our Goals for Advanced Quality
Outcomes Program:
• Data was based on perceived quality
and we wanted to move to actual
quality using data
• We wanted to educate patients and
team members about value of network
that was based on objective quality
data
• Automate our systems to track quality
and maintain a preferred provider
network.
Local Problem
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Advanced Quality Outcomes is a program at TriHealth that
measures quality in post-acute for the management and
determination of the preferred provider network that is based
on objective quality data.
Advanced Quality Outcomes
Monthly on-site
education sessions at
SNFs
Team member
education on
preferred provider
network to improve
utilization
Monthly AQO meeting
to share best
practices, open
communication and
share outcomes
SNFs document
discretely by disease
state in TriHealth
instance of Epic for all
SNF/HC discharges
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Determining
Preferred
Provider
Network
Tactics To Drive Outcomes
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Tactics To Drive Outcomes
Sharing Performance with SNFs
• Report cards outlining quality and
utilization shared yearly
• Comparison data is also shared
to understand where there are
opportunities to improve and
where they are outperforming
others in the market
• Utilize Epic Healthy Planet Link
documentation, MSSP/CJR
claims data
Preferred Provider
Scorecards
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• Share data with our patients about preferred provider outcomes
• Care Coordination and Providers utilize data to make referrals
• Utilize actual data to drive decisions versus perceived data
Tactics To Drive Outcomes
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• Share data with our
patients about
preferred provider
outcomes
• Care Coordination
and Providers
utilize data to make
referrals
• Utilize actual data
to drive decisions
versus perceived
data
Tactics To Drive Outcomes
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Governance Solution Design
Implementation
Barriers &
Challenges
AQO
Project
Structure
Key Strengths:
• Strong culture of successfully
partnering with independent
providers
• Strong culture of internal multi-
disciplinary team work and
collaboration
• Information Systems is seen as a
member of the care team
Technology Project Structure
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•Monitoring of Post
Acute Quality Data
Began
•Documentation via
Excel
2015
•Skilled Nursing
Facilities began
documenting EPIC
•Keyfob access
2016
•Added Home Care
documenting in EPIC
•Continue with SNF
documenting in EPIC
•Keyfob access
2017
•Transitioned to
Healthy Planet
•Web Based- no
keyfob access
needed
2018
Technology Evolution
TriHealth continues to improve our post-acute
documentation platform to provide easier and more
secure access for our post acute providers
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Analytics
• Over 356 discrete data points available.
• Single report combines both hospital and SNF/HC data.
• Refreshes daily.
• Can pull data from any date range.
• Can be displayed in nearly any visualization platform.
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Documentation Compliance
0.00%
20.00%
40.00%
60.00%
80.00%
100.00%
120.00%
Ortho Other Cardiac Wound ID Pulmonary Total of All
Documentation Completion Rate by
Diagnosis Category for Post-Acute SNF
Providers
Preferred Providers Other
Preferred provider data demonstrates more engaged participation
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Quality Outcomes
15.19%
15.56%
16.80%
13.59%
11.63%
68.50%
69.30%
71.30%
69.00%
73.90%
April 17-June 17 July 17- Sept 17 Oct 17- Dec 17 Jan 18- Mar 18 18-Apr
New Medicare SNF Patients Discharged to Preferred
Providers Demonstrates a Decrease in
Readmissions
% of Readmissions
Volume of Patients Discharged to TriHealth Preferred Provider SNF
Linear (% of Readmissions )
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Quality and Financial Outcomes
Reduced SNF
Expenditure
$2,050,000
Reduced Labor
Expense & Cost
Avoidance
$528,123
Reduced
Readmissions
7%
Total ROI
$2,578,123
